Provider Demographics
NPI:1215198429
Name:EYE TO EYE ASSISTED LIVING HOME
Entity Type:Organization
Organization Name:EYE TO EYE ASSISTED LIVING HOME
Other - Org Name:HOUSE OF JOSEPH
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PCA
Authorized Official - Phone:907-222-2480
Mailing Address - Street 1:3705 ARCTIC BLVD
Mailing Address - Street 2:APARTMENT 1211
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5774
Mailing Address - Country:US
Mailing Address - Phone:980-722-2248
Mailing Address - Fax:
Practice Address - Street 1:3705 ARTIC BLVD
Practice Address - Street 2:#1211
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5774
Practice Address - Country:US
Practice Address - Phone:907-563-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKRL9768305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization